The plantar plate is a fibrous like framework that is situated on the plantar side of the metatarsophalangeals (toe) joints of the foot. Biologically they are the same as the meniscus within the knee meaning these are built to endure a lot of compressive loads and support the joint surfaces. It's really a a thickening of the bottom part of the joint capsule that is all around that joint to keep the joint lubricant in the joint. The vast majority of fibers in it are aligned longitudinally in the similar direction as the foot points, so it will be able to hold up against lots of tension forces. The collateral ligaments on both sides of the joint furthermore connect to the plantar plate, to help give the joint greater stability. The role of the plantar plate is to try to support the weight of the body and limits dorsiflexion of the metatarsophalangeal joint.
Since this plantar plate is designed to tolerate those high forces, sometimes the forces can be so high or the tissues is weakened for several possible reasons, it can turn out to be painful or maybe have a small split in it. This isn't usually something which occurs quickly and develops slowly over time. The pain is frequently on weightbearing under the joint at the base of the toe. Palpation of that region is usually fairly painful. Usually the diagnosis may be validated by having an ultrasound evaluation. Previously the signs and symptoms could possibly have just been dismissed as a metatarsalgia which is not really a diagnosis and just suggests pain round the metatarsals. Today much more is understood regarding this plantar plate and just how it makes symptoms, the treatment could be far better directed to remedy it. The important thing to fixing this problem is to relieve stress on the plantar plate and to do that the toe must be held in a plantarflexed posture with strapping. This often handles most instances.